To analyze the factors associated with prematurity in reported cases of congenital syphilis in the city of Fortaleza, Ceará, Brazil.
Cross-sectional study conducted in ten public maternity hospitals in Fortaleza, Ceará, Brazil. A total of 478 reported cases of congenital syphilis were included in 2015, and data were collected from notification forms, from mothers' and babies' medical records and from prenatal cards. For the bivariate analysis, Pearson's chi-squared and Fisher's exact tests were used, considering p &lt; 0.05. Multiple logistic regression was conducted, presenting odds ratio (OR) with a 95% confidence interval.
We found 15.3% prematurity in pregnant women with syphilis. The titration of the VDRL test &gt; 18 at delivery (OR 2.46; 95%CI 1.33-4.53; p = 0.004) and the non-treatment of the pregnant women or treatment with drugs other than penicillin during prenatal care (OR 3.52; 95%CI 1.74-7.13; p&lt; 0.001) were associated with higher chances of prematurity.
The prematurity due to congenital syphilis is a preventable condition, provided that pregnant women with syphilis are treated appropriately. Weaknesses in prenatal care are associated with this outcome, which highlights the importance of public policies oriented to improve the quality of prenatal care.
The prematurity due to congenital syphilis is a preventable condition, provided that pregnant women with syphilis are treated appropriately. Weaknesses in prenatal care are associated with this outcome, which highlights the importance of public policies oriented to improve the quality of prenatal care.To evaluate the annual variation of oral health and primary care coverage, the tooth extraction ratio, and the average of supervised toothbrushing in Brazilian municipalities according to social development and population size.
Public secondary data were analyzed. The outcomes were health service indicators (oral health coverage, primary health care coverage, tooth extraction ratio, and average of supervised tooth brushing) estimated for all Brazilian municipalities annually from 2008 to 2015. Mixed-effect multilevel regression models with random intercept and slopes were fitted with a cross-interaction term to estimate the annual percent variation according to the Municipal Human Development Index (MHDI) and population size.
Municipalities with low MHDI presented an annual increase in oral health and primary care coverage of 2.65% and 2.23%, respectively, which was significantly higher than municipalities with medium and high MHDI. Oral health and primary care coverage were 69.26% and 35.00% lower among municipalities with a large population. Municipalities with medium and high MHDI showed an annual decrease in tooth extractions of 5.15% and 5.02%, respectively. An annual decrease was observed in the average of supervised toothbrushing of 9.81% and 4.57% in municipalities with low and medium MHDI, respectively. The tooth extraction ratio was higher among larger municipalities; the relation is inverse for supervised toothbrushing.
The access to primary care and oral health services increased in Brazil, while a decrease occurred in mutilating treatment and provision of preventive actions, with disparities among municipalities with different MHDI levels over time.
The access to primary care and oral health services increased in Brazil, while a decrease occurred in mutilating treatment and provision of preventive actions, with disparities among municipalities with different MHDI levels over time.To analyze the distribution of adverse events following immunization (AEFI) in pregnant women in the state of Minas Gerais, between 2015 and 2019.
This is an epidemiological, descriptive study conducted with AEFI data from 2015 to 2019, recorded in the Adverse Events Surveillance Information System, in the state of Minas Gerais (MG), Brazil. A total of 670 AEFI were analyzed in pregnant women. The estimates were presented in proportions, according to the year of occurrence, health macro-region of Minas Gerais and immunobiological administered.
The year in which there were the most records was 2017 (36.8%). Among the 14 macro-regions, the ones with the lowest and highest number of records were the Vale do Jequitinhonha (0.5%) and Center (31.8%), respectively. The vaccines contraindicated during pregnancy represented 27.6% of the total notifications. The total of 69.5% of the cases were considered immunization errors. https://www.selleckchem.com/products/ttnpb-arotinoid-acid.html In 75.9% of the records, the variable of medical care was ignored, and in 73.7% of the cases no information on the evolution was presented.
This study shows the need for continuing education for the multidisciplinary team, in order to reduce cases of AEFI and ensure the adequate completion of notifications by health professionals.
This study shows the need for continuing education for the multidisciplinary team, in order to reduce cases of AEFI and ensure the adequate completion of notifications by health professionals.To analyze user satisfaction in relation to access, infrastructure and quality of Primary Health Care (PHC) services in Brazil.
This cross-sectional study was conducted with data from 114,615 users linked to 30,523 health teams, obtained through the database of the Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB -National Program for the Improvement of Access and Quality of Primary Care). Independent variables related to access, infrastructure and quality of services in PHC were studied. The outcome, user satisfaction, was measured using the variables "if given the option, I would change the staff or health service" and "I would recommend this health service to a friend or family member." To assess satisfaction according to independent exposure variables, Pearson's chi-squared test was used, considering a significance level of 5%. Descriptive analyses of the variables were performed using absolute (n) and relative (%) frequencies.
User satisfaction was associated with the variables of access (p &lt; 0.001), infrastructure (p &lt; 0.001) and quality of services (p &lt; 0.001) in PHC. The proximity of the service, attention to spontaneous demand, listening and the respect of professionals to the singularities of the patient, as well as the problem-solving capacity of the services, without the need for referrals to others and the good infrastructure, were related to user satisfaction.
To ensure the improvement of the quality of services offered in PHC in Brazil, the aspects of user satisfaction identified in this study should be considered in the organization and management of services.
To ensure the improvement of the quality of services offered in PHC in Brazil, the aspects of user satisfaction identified in this study should be considered in the organization and management of services.